4192 Amberleaf TrINSPECTION REC4R
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITE ADDRESS:
?: F, Ft?? i'r 1 F I
I PERMIT SUBTYPE:
I I " ,i4 11
I A r tYt r,l i ? , ' i' 1 I I I
1N• 64f,60-1
tr4? 4?1
r ? I K f,i APPLICANT:
?
TYPE OF WORK:
111 `:t'.h i I' i ! oifi
f''1' b16i I
rw!:?
! kj( r E0 r, ft I I r"4I r
i rr I?A I i Orv
A'. 1M'0Fftt1r;A
? 7
? L 'I
Permit Holder Date Telephone !k
SEWER/
WATER
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEA77NG
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE B
AIR TEST tZ ' 18
FINAL PLBQ
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATIOfJ
METER
FLUSH
MAINS
CONDUCTIVfTY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION
'CIT'Y OF EAGAN
3830 Pilot Knob Road
I Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: A
, .. ,
- PERMIT SUBTYPE:
?
PERMIT TYPE: ? it VI j M
Permit Number: • ? ?' 30
Date Issued: 0;. / i
.?
, . • ,. ??
TYPE OF WORK:
INSPECTION .. . D
n
i
i
r MARK.ti : :, & LJ f' i. tjk s E 1 RMIff f
Permit No. Permlt Holder Dete Telephone #
ELECTRIC Al(???
PLUMBING (5?g 7. #e?y-1?9
HVAC 4
Inspection Date Insp. Comments
FOOTINGS -2.6,47 N449
FOUND
FRAMING ?
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST r! ir
ROUGH
HEATiNG
GAS SVC
TEST 1 [ ri
61,1-2 ?
INSUL 7 gWZ
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG fl
ORSAT
TEST
BLDG FINAI
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
Address 4192 aMSEtu,M TtAII, Zip 5512 3
Lot - 18 Blk l Sub RoONEr
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date; /D (/ ?'j -,7 Yes No Inspector:
Final grade (6" from siding) r/
Permanent steps (garage) V_?
Permanent steps (main entry)
Permanent driveway G?
Permanent gas v
Sod/Seeded grass ?
Traillcurb damage
Porch ?
Basement finish ?
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shu6off of water supply to
the outside lawn faucet before freeze potential exists.
Contad engineering division at 681-4645 before workiag in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contracror Copy
S?/?+? ? ?^ OFFlCE USE ONLY This requeslwid 18 monlhs (rom valien ? dot?nl?i Hs box
7 ? 1 /
I I
I?II
I
I?I II I I II II II III? I I
I II III?/?/ ?/'
?
III
I II
II
I V
E
T OR TYP
PL
?/ O
Naquen Dore ga?pMn mspechon mqutredz es ? No Inspecnon OiMr Than RougMn ? Ready Now 0 Coll
4-BD- q9 ?'lo? musi call ?he i-specmr when reody) Ready
I, Oicensed mnhacror ? owner hereby request inspeclion of the above ele ical wor S?
lob Address (Sreet, B., a Rooce No ) Gry , P@CdEW
,
(-I(qQ O 1 ' ! ' :? QY)
$echon o Township Nama or No. Range No Fre No Couny ?
l?
Oc<upant Phorie No.
Powrr Sopplle Addrais
QWIG
Elechiwl ConhaUw (Company Name) Conhacbr Lcenie IJo.
Elecl. Only?
Moskr Lic No (%ant
Am ?5
Moilmg Address jCOnnoclor or Owner Pehoiming Irabllonon)
4C)s -d Je n brrx?)U? 3n PctnlL rn?J .???143
Autlwnzed Signmure (Convocror « Ownn Performng Insmlloriw) Phme No
J- +? %3-kcc)
E8-00001 A-I 7 8/9b STATE BOAND COPY - SEE MSi1iUC710N3 ON BACK OF YELLOW COPY
REDUEST FOR ELECTRICAL INSPECTION 7`3 *7
44 77 '? ? , Minnesofa State Board of Electriaty
1821 Universiry Ave., Rm. 5128, St. Paul, MN 55104
5/C? Phone (612) 642-0600
Home Du lex A t. Bldg. Othe::
m New Addn
Commercial Indushiol Form I l Remod Re air
Air Cond. Htg. E uip. Water Hh. Load Mgmt. Olher.
Dryer Ran e Elec. Heot Temp. $ervice
"X" above fhe work covered by fhis request Enter remarks in fhis spoce and on the bnck of the while cbpy only.
A?c? on ??e ?? g3,r?c-17
Calwfale Inspeclion Fee - This Inspection Requesf wdl nof be occepfed wifhoul the rorrect /ee:
Other Fee # Scrvice Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Pork Stoll 0 l0 200 Am "pio 1 -- LS 0 to 100 Amp '"6-
$heet Llg./TraHic Sig. Above 20Am s Above 100_Amps
Tronsformer/Generotor INSPECTOR'S USE ONLY TOTAL 5o
Sign/Outline l)g. X(mr. -
Alarm/Remote Conhol
Swimming POOI I herereni Ihot I Ins kd the e ?? ihe da?e::m? d
Irngo}ian Boom RoogMn oare.
S
eciQllns
eclion ?
p
p
Invesfigotive Fee J F??al
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
?5 O? OFFlCE USE ONLY Thu raquesl roid 18 monMslrom validaHon dok prinled in this box.
? H77??
IIIIIIINNIIIIIII?IIIIIIIIIIIIIIIIIIIIIIIIIIIvs/4?1,?
/yRv?
v
* 11 4 4 6 7 5 9 3 aC PLEASE PRINT OR TYPE ?S
Reqvesf Dam RwgMn inrpanwn reqoired2 ? N. I
?d Insect:an Olher Thon Roughln Q ReoAy Now ? WAI Coil
w?? ,
r? oare aeaay.
I, icensed conkoctor 0 owner hereby request inspecfion of the above elechical work at:
Job Address (Sneei, Ba,, or Rome Na I Crry 2ip Cade
19 r LQ-0'( T. ;E?a an
Secfion No. Township Name or No Range No Firc No Ca
uny
h
W?
Occuponr
C
W
-?'
d Phme No
o
n
n
PowerSuppLer Addreu
aY..?1a '?
Elechical Commcror (Campony Name) Connocbr Lcmu No Mosten cc No i%am Flev Only)
5unri ? 4iic- C?aoi? ?m a
Mailing Address (Conhactw ar Ownrr Performi'g InsbllaM1On)
HC rc1 pue- kb
p n Pbn m 55'-E43
Aulhwiud Stgnmure ?Cankmor or Owmar Perfoimmg Inswl
lorio
Phone No
SKa
I 'Mcb- ";?)w I
U/Yb , STATE BDAflD COPY - SEE INSiAUC710NS ON BACK OF YELLOW COPY
446-7593
??97
REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electricity
1821 Unrversiry Ave., Rm. S-128, St. Paul, MN 55104 -
Phone (612) 642-0800
Home Duplex Apf Bldg. O er: New Addn
Commercial Indusfrial form Remod Re air
Air Cond. Htg. Equip. Wofer Hf oa g. fher:
Dryer Range Elec. H t emp. Senice
"X" above fhe work covered by fhrs requesl fn e and on the bnck of ihe white copy only.
Colculote Inspedion Fee - This fnspxfion Request wiN nof be acrepfed wifhouf the corred fee:
Other Fee # Service Entranrn Size Fee # Circui[s/Feedere Fee
Mobile Home Park Stall 0 ta 200 Amps 0 to 100 Amps ? -
Sheet Ltg./Traffic Sig. Above 200_Amps A Amps
Transformer/Generofor INSPEC70R'S USE ONLY
/ TAL
$ign/Oufline Lfg. XFmr. ?.
Alorm/Remote Contml ?
Swimming Pool
I here ceni Ihot I mspecled eleclnml inslallman d herem on Ihe daks sMled
Irrigahon Boom Ro„yki„ p?e
Speciol Inspeclion
Imestigafive Fee
THIS INSTALLATION M
' p
AY HE O Final
RDEREO DISC C O IF WRHIN 8 ?NTHS.
? -CITV' OF EAGAN PERIVIIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 7 3 0
(612) 681-4675 Date Issued: 0 q/16 / 9 7
SITE ADDRESS:
P.I.N.: 10-64560-180-01
4192 AMBERLEAF TR
LOT: 18 BLOCK: 1
ROONEY
DESCRIPTION:
B°uildingwP,ermiC 7ype
1BUildin4 W6,r•k? Type
-`UBC" YJacupancq`?_.s
yj?e
?Constructzqnr "T
Zoning _., _
'Buildi,ng Length
Bu,i l.dl ngWidth _
`. g?uilding storie&
f_
r,e Feet;__., .:
Ceiasufi-=Code
SF DWG
NEW
R3/U1
VN
R1
73
46
2
2,127
101 1 - FHM. DETACH
? 5 ? a3
?'.1
REMARKS:
S & W f'LBR: ELANDER
FIEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
$1,292.25
$839.96
$90.50
$950.00
1@0
$3,172.71
$181,000
MISCELLANEOUS $1,539.50
Tota1 Fae $4,712.21
CONTRACTOR: _ apPiicanr. - sr. LIc.OWNER:
L,UNDGREN 6ROS CpNST 14731231 0001423 LUNDGREN BROS CONST
935 E WAYZATA BLVD 935 E WAYZATA BLVQ
WAYZATA MN 55391 WAYZRTfl MN 55391
(612) 473-1231 (612)473-1231
?
I here6y'acknowla.dge that ZhaW-eread.this°s,pplic.atiom and state that Che
infiormation-ia carrect and,agre,e 'td campLywiCh al'1 applinakzleState o'f Mn-
Statuties and City of Eagarn.Ordkoanbes.°, 4 " < <
flr??n R?Q i rn?
APPLICAN PE I7EE SIGNATURE ED B SiONATURIE
ities Diizital Oualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
i ..'-:?-"•.'??' _`?' J: 6: t
Y• 1.
...:'??,y.p.
?
Y
? ..-,. ?-
l?r;,.-;:
. ,. , . . . . . . . °. ,; :? m:'.... ?, i •? ? ..? i . , ,
??p 3830 PILOT KNOB RD - 55122
?J UILDING PEFYMIT APPLICATION (RESIDENTIAL) ?y7?a• ??
r[ (? (Retl 681-4675 ??
Naw Conslruclion Reauiiements RemodeVReoair Reavirements 7
? 3 registered sfle surveys ? 2 copies of plan ? 2 copies of plans (include 6eam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior addkions 6 decks)
? t energy calculations ? 1 energy calculations Tor healed additions
? 3 copies of tree preservativn plan H lot platted aRer 711/93
required: x Yes la SO,
DATE: CONS7RUCTION COST: /?? • U ??
r-
DESCRIPTION OF WORK:
STREET ADDRESS: ?L?&2 ??A 1L?
LOT 166 BLOCK ? SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: LC66664it/ /-IfM?aJrUSTiE'l(CT,kPhone #: V23-123 /
.... ....
Street
?G .
,Z_ Vz
City:?????Tiq
state: ?"?'? zip:,Z-.? B g/
Company:
Street Address:
Citv. State: _
Company:
Name:
Phone #:
License #• l y/ 2
Zip:
Phone #:
Registration
Street AddressCiry: State: Zip:
Sewer 8 water licensed plumber: `--?V,2) ? . Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that tfie information is coRect and agree to compVy with ail
applicable State of Minnesota Statutes and City of Eagan Ordinances,
Signature of Appiicant:
OFFtCE USE ONLY
Certificates of Survey Received Yes _ No E VED
Tree Preservation Plan Received V Yes _ No '??r? 7 1997
3UILDING PERMIT TYPE
- 01 Foundation o 06 Duplex
02 SF Dwelfin ? 07 4-plex
-1 03 SF Addition ? 08 8-plex
:1 04 SF Porch ? 09 12-plex
- 05 5F Misc. ? 10 _ plex
WORK TYPE
1 New
? 32 Addition
? 33 Alterations
? 34 Repair
uENERAL INFORMATION
? 11 Apt./Lodging 11
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
0 14 Fireplace 0
? 15 Deck
? 36 Move
? 37 Demolition
?.onst. (Actuaq _ v^I Basement sq. ft.
(Ailowable) v N Main ?vel sq. ft.
UBC Occupancy 2-3,vq 2 •sq. ft.
Zoning +2- 1
- sq. ft.
u of Stories cx • sq. ft.
'_ength TZ ' y" sq. ft.
Depth -v-' Footprint sq. ft.
APPROVALS
7'lanning Building
16 Basement Finish
17 Swim Pool
20 Pubiic Facitity
21 Miscelianeous
14? 50 MC/WS System
?
_ i-N ='o City Water ?
i 2c? c( Fire Sprinklered
&'t? PRV
Booster Pump
Census Code. 4oi
?zoi Z SAC Code v 1
Census Bldg ?
Census Unft ?
Engineering
Variance
Permit Fee
Surcharge
Pian Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Traits Ded.
Other
Copies
Valuation:
L?, sEV^ e?...?
.?-------
SP ?l 2 3 .'7S
g.gsxpp.S
3q y ?
2u ?
,?.
9arv.e
2 ?a-
g0? 2Z
3qrr 8
-?.s+r+z
Total:
% SAC ;
SAC Units '
$ 181 , ooo.-
t 1 ? 7. S
3
I i
fVSO.f J? ? 5'H=
1100
z72
?S
-------
12- q4/
G -F -; +A ab I (, _
ar; st .s
? 8 1 3o'S , e/
G9i 8-7(-, --
1n, $ 2,2 . -
!b'C.a , -76.a.,j
,?
I
.. ...
?
? ???
2422 Enterprise Drive
Mendoto Helghts, MN 55120
1914 FAX:681-9488
1
-
(812) 68
N?7Ep
ii utio suR?rops • ar? cncwc
MCMilEC75 625 Hi9hway 10 n7_E.
neBr n
ng
??r
DATE Blaine, MN 55434
7g3-?880 FAX: 783-1883
*** BUIIDiNG INSPECTiONS DEPT,
LUNDGREN BR4S. CONST.
` Certificate of Survey for:
4192 AM6ERLEAF T RAII
/ iBENCH MARK
/ TOP OF PIPE
? ELEV.=922.66
i
zS i
Is1a.5 tql??G1' ?916.5 h'OG?,1,G 17
' 4.17
i 9?? r? i/r S3?8 917.35 5?.3?.?4.
lo F I
r `137,].4 922.9 925.27
43 !
x922.8
' - ?
924.0 919.8
q<_ `o
too ' 915.0 ?3 8? 924.3 920.2 x 920.7 ?01 CP
5 x
,0 . 924.7 922.7 `5 ?
924. ? `'- 16
_ w 66 x
t ,,O 1t ?A Os
.
?o 1 8 G th
o J 9 a11 W
g% ZW
? \R,'Q ? 914.6°'
k,? o x 917.0 7 ? ? 814. ? po 9 5- 916.5 9182
917.8
? \ \\ ?,? ?i x916.1
.? ? 303 5 X\N ?
O ? AA
914.7 11\0
?w
x ?
lp 914.2 9T43 ? .
914`, -'
sv?
913.bpe?Qj? ?
914.4
? ? r 19 R? 5?
i
910.5 BENGH MARK'
TOP OF :PtPEF
?\ \ ELEV.=91
.G,6 y
? '
S??`? `?
NOTE: PROPOSED GRpDES SHOwN PER GRAOiNG PIAN BY: PIONEEN
NoTE? BVILDING OIMENSIONS SHOwN ARE FOR NORiZON7AL AND VER7IGL LaCATION
OF S7RUCNRES ONIY. SEE MCHIIECTUAL GLANS FOR BUIIAINC AND
FOUNUAYION OIMENSIONS.
NOTE: NO SPEdFIC SOilS INVESTIGAl70N MAS BEEN COMPLMD ON TMS L01 BY THE
SUR`/EYOR. THE SUITABIL4T'I OF SOILS TO SUPPOFT 7ME SPECIFlC HWSE
PROP0.5E0 IS NOT TFIE RESPQN5161Un' aF 1HE SURVEYQR.
915.9
EXISTING
HoUSE
w-?,,1 ?9 ?\?-? i?
?L..
F-AGc'LN EPP- "- w F lyL `A'TION
LOWES7 fL00R ELEVATION: 910,U
TOP OF BLOCK ELEVAriON:
GARAGE SLAB ELEVATION:
NOTE: 1MI5 CER7IFlCATE OOES NOT PURPORT TO S710W EASEMEN7'S 0"rH,F`R THAF X OOO.DO DENOTES E%iSTiNC ELEVATION
iNOSE SNOYM ON THE RECOHOEO PIAT. ( 000.00 ) DENOTES PROPOSEO ELEVAliON
r. =- DENOTES ORAINAGE AND UTIl1T7 EASfMENT
NOTE: CONTRACTOe MU57 VERIFY DRIVEWAV DESIGN. DENOTES ORAINAGE PLOw DIRECiION
ro01E: OEnRINCS SHOWN ARE 9ASE0 ON AN a55UMED OANM -r DENOTES MONUMENT
p DENOTES OFFSET HUB
WE HEREBY CERTIFY TO LUNDGREN BROS. CONST. 7HAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEr OF THE 80UNDARIES OF;
LOT 18, BLOCK 1, ROONEY ADD9T10N
DAKOTA COUNTY, MINNESQTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED 8Y ME QR
UNDER MY DIRECr SuPERhStON THIS 11TH DaY OF OCTOB6R. 1996. ^
ei _n?e? cn- ! ?PA(]NFFR FNC?I EN?.A.
SCALE : 1 INCH = 30 FEET
7 5WK REVISEO 3-14-97 SHOW NEW HOUSE
e
1 0'd
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
?
n
i
?
5
?
m
m
?
?
?
?
?
?
?
?
?
?
?
PROPERTYLEGAL:
DATE OF SU*GEY: / 6
LATEST REVISION:
?o
P??
??
[?3' ?
B' ?
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• Buitding PermitApplicant
• Legaldescription
• Address
• North arrow and scale
• House type (rambler, waikout, split w/o, split entry, lookout, etc.)
• Directional dreinage arrows wffh slope/gradient %
• Proposed/exassting sewer and water services & imrert elevation
• Streetname
• Driveway
ELEVATIONS
Existing
/
??9- ? • Sewer service (or Proposed)
o? ? ?
? ? •
• PropeAy comers
Top of curb at ffie driveway
? ? • Elevadons of any exissting adjacent homes
Prooosed
W' " ?13 13
13
e o • Garegefloor
/
a ? 13 • First floor
2--?0 0 • Lowest exposed elevation (walkouUwindow)
? • Property comers
0?
[] 0 • Front and rear of home at the foundation
PONDING AREA (iaonlicable)
• Easement line
? rd--?o • NWL
? er'o • HWL
• Pond # designation
• Emergency Overflow Elevation
DIMENSIONS
01"?13 a • Lot lineslBearings 8 dimensions
0-? 0 ? • Right-of-way and street width (to back of curb)
• Praposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (.e. all struclures requiring permanent footings)
• Show all easements of record and any Cily utilfies wifhin those easements
O? ?0 • Setbacks of proposed structure and sideyard setback of adjacent eAsting structures
El0 • Retaining wall requiremgp#s, if anY,
Reviewed:
Date
January 1996
cRMi oaeieLocvRMr Frn
..
Lun???EII
BRO5' EXTERIOR ENVELOPE AV[RAGE U COMPUTATION SHEFFIELD PLAN
CONSiRUC110N
INC
Lot/gBlock /
Site Address ??9a, a.?z?j-=li2C?-?-L
?
R& U Factors _ R ll
Opaque Walls .043
935E Wayzataf3lvil - -
Myzata Wa11 Fraining Areas .09 ,
Minnr.suia55391 Ceiling Insluation Area .023
(612)473-1231 Cei 1 i ng Frami ng Area .027
Rim Joist .04
Masonry Wall .469
Windows .35
Doors .31
Skylights .55
1) Lower Level (Qasement)
Total Exposed Wall Area seeo
Opaque Wall Area a? X (U) .043 =_??
Wood Frame Area J? X (ll) .09 =
Rim Joist "r X (U) .04 = -?
Exposed Block ? X (U) .132 =
Window Area ? X (U) .35 = 10? ?
Sliding Glass Door ?(7 X (U) .35
Door Area X (U) .31
Total .? ? ?SJ
LunNW
BRO5' 2) First Or Main Floor
coNSraucnoN
WC Total Exposed Wall Area
Opaque Wall Area
Wood Frame Area
Rim Joist
Window Area
935 C Waytala Bivd
Wlylaia Sl i di ng Gl ass Door
MmnCS01255391 Door Area
(612)473-1231
3) Second Floor If Two Story
Total Exposed tJall Area
Opaque Wall Area
Wood Frame Area
Window Area
Sliding Glass Door
Door Area
4) Total Ceiling Area
Wood Frame Area
Opaque Ceiling Area
Skylight
X (U) .043 =
Y, (U) .09 = ?QQ
X (U) .04
X (U) .35
ao X (U) .35 - ?
% (U) .31
To ta l
1)l'7.6
o?cX (U) .043 =
x (u) .09 =
? X (U) .35 = M'd'; 3
' X (U) .35 =
X (U) ,31 =
Total
?t
0 3dpc-l
X cU> .027 _ ?73
?A4,6!X (U) .023 = ?ii?•(?J?
-? X (U) .55
Total
LunaGR(n
BROS.
CONSTRUCTION
wc MINNESOTA U FACTORS Total Exposed Wall Area O&X .11
MINNESOTA U FACTORS Total Exposed Ceiling ?y,, ?
Area /?aL-1 X .026 = 3? l?
(A) Total = ??
935 E. WaymLi fllvd
/ ,??- G C?
Wayrata Item lj?,7s+ Item 2I?.>?'?J+ Item 3/,9C t Item 4P -3,/ 4)7
Minnesola 55391
(612)A73-1231
If Total Of Items 1-4 Is Less Than Item (A), Buildiny Complies With
SBC 6006 (C)s
..tl?
L?
BL
cirr use oNLv
RECEtPT#:
RECEIPTDATE:
1997 PLUMBING PERM{T (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4875
Please complete for. . single family dwellings
. townhomes and Condos when percnits are required for each unit
. backflaw preventer for underground sprinkler system
FIXTURES EACH NQ. TOTAL
Shower 3.00 x ,_L =
Water Closet 3.00 x 3 _-
Bath Tub 3.00 x 2 =
Lavatory 3.00 x S- _
Kitchen Sink 3.00 x
Laundry Tray 3.00 x 1 =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x f =
Floor Drain 3.00 x
Gas Piping Outlet ' minimum - 1 • 3.00 x I _
Rough Openings 1.50 x 3 =
Water Softener "for dweilings under consWGion 5.00 x =
Water Softener • for extsting aweliinp 20.00 x =
U.G.Sprinkler `fordwellingunderconst. 3.00 =
U.G. Sprinkler ' foTexisting tlwelling 20.00 =
Alterations ' W existing residence 20.00 =
Water Tum Around 20.00 =
Private Disposal System ` Dak Cty lic 75.00 =
(new and retur6ished sysUems)
Private Disposal Systems • anandonment 20.00 =
STATE SURCHARGE .50
D'Q
TOTAL
I hereby acknowledge that I heve read this application, sfate that the information is corteU, and agree to comply with ell applica6le City
of Eagan ordinances. k is the appi'icaM's responsibility to notiy the property owner that tha City of Eagen assumes no liability for any
damages pused by the Cily during its nonmal operetional and maintenenca activities M the hdlities wnstruded under ihis pertnit within
Ciry propertyhight-of-way/easement
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
STREETA/D?dRESS: <<?•n--
CITY: S1/Wkodtv
5,
1,f TELEPHONE#:44S-4(-,iZ-
STATE: p: 5-23 )9
u //P ;/V/
SI E O PE MITTEE
F- . CITY USE ONLY
l/ y/
LOT ? BL RECEIP'1' #: /'Y'//v ;2-
SUBD. ?pfYx? / RECEIPT DATE: -1/? 9/9 /
1997 MECAANICAL PERMIT (RESIDENTIAL)
CTI'Y OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612)6814675
Date:
Complete tlus section onlv if you are installing I3VAC in sinele familv. townhome. or condos that are
under construction and are not owner /occuoied.
• HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
• Gas oudets (minimum of one required @$3.00 ea.) 3• t!?-
• State Surcharge: .50
• TOTAL: 33,5?0
Complete this section oniv if you are remodeline, adding to, or reaairine eaisriug single familv
dwellings, townhomes, or condos.
_ Add-on fumace _ Add on air conditioning
_ Add-on air exchangez, i.e. Vanee system, etc. _ Other
Minunum fee applies to all remodel or add-ons of existing residences $ 20.00
State Surchazge .50
Total: $ 20.50
SITE ADDRESS: w A-"C e ItJ
OWNERNAME: 61-05. PHONE#:
INSTALLER NAME: 9 (k,?„?4Er `f LLr4?, C4 C PHONE #: ??( S`-?yR Z
STREETADDRESS: !N l,L?an 'br.
CI71': r] ?µPOtiL STATE: ? ?? • ZIP:S?.37°?
. .n
cirr use oNLv
L _ eL - RECEIPT#:
SUBD. RECEIPT DATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CtTY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for.
DATE:
CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: . $25.00 minimum fee 911% of contract price, whichever is greater.
• Processed piping - $25.00
? State surcharge of $.50 per $1,000 of pgrmft fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (iMaROVeanENrs oNLv)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE #:
SIGNATURE:
SIGNATURE OF PERMITTEE
• all commerciaUndustrial buiidings.
? mutti-famity buildings when separate permits are po required for each dwelling
unit.
CtTY INSPECTOR
r miji i
rnuivc ivu. • nuy. iv •? ?W•??mii i.
L 0 ?
SiJBL?
New Raceipt # o o? w
Ttzceipt Date ???
order For Payment
Data."rRf? 1?!:? ?aquoct fi?r Iacpectinn 1VnmhPr nn thic jnh ?"P LI Fi - 77_1
DateFiled.._. 11
Elecuica! Installer License ?Io. C? ! ?,S 0
Owier/Occupx[rt_ Cs?s County Dnk..+,.
JobAddress
Additional Roughh-in iaspection was reqixired.
-ZA shoriage of fees on the above jab.
Reinspection Fee.
A Copy of this order must be returned with payment to the;
Eagan Municipal Center
3830 Alot Kaob Road
Egan,MN. 55122
Phone- 6814600
Fee
Plese retum this with a check in the amouut of $.3 . 5C?I payable to the City of Egan.
Tlie above order must be conipGed with by (date)
Etecttical Inspector Cluis Brinkhaus, 1026 Oak itd_, 3hakopee, Mn 55379 (612)1969615
!:;T. i'v r:)F- f::,AG,Ard
(:;A<ili:f.Ei(.^. :i TE.E'MINAI._ 1`lt7u 893
D;o'rl:=;; til019r3 TI:MI_; i.Q28;48
]I.ia
A!Flf1F:° ALl'r,M:,T.CC LAl;AGE Lir,•C3R .. !=f•PLC;r
30'I.il ..L`lf)I. 092 i1Ni.fl;..hiL'clF1P `7'.I,.f 10
21t>" 111ii1-1 All'?t? ;1NiS?sFR'.I'.!r',F WWi
. .. . ,! , _, ., ?i p ? t N'.yW ?. ..r 1. .1:1
r? ?N90?;s;
n:,;i.R ,P,, NrlNC;'
+.?r6r?R;? ? ?:„;;::???v,;;;? r'?:c?Y>;:Y„?i??k::;.>l-? ;:k',•l?:t'n+;:i:•.'d ??;:kS:
? CITY OF EAGAN
3830 P;(ot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
RUII_pING
03399[
1111019s
SITE ADDRESS:
PeI,N.: 10-64560-180-01
4192 AMBERI.FAF TR
LOl'r 18 BLOCK: 1
RDONEI'
DESCRIPTION:
'-6Fl5 INSERT/GAS LINE
Buildinq P.grmit i"ype FIREPLACE
tfuilding Work Type AL7ERA7TON
Census Cocle 434 NLT. R[SSDENTIA1.
?
?F
i
REMARKS:
CI-IIMNcY/FLUE MU57 RE .LNSPECTEO BEfORE CUidCCAL.TNG.
FEE SUMMARY:
Base Fee
Surcharge
TotaL Fee
$5P.00
$50.50
CONTRACTOR: - ApPlicai,c - sT. i.r.c. OWNER:
NU7(IMATTC GARAGE p00R 15712525 0001990 GLASGROM DAVID
220 NE 77TH AVE 4192 FIMBERLEAF TR
FRT.DIEY MN 55432 GHGAN MN 55122
1612) 571-2525 (651)6E31-8454
r
I hereby acknowledqe that S heve read this appiication and st'ate That the
information is correct- anei aqrea L'o c:o+nplv wir.h a11 applicable State of Mn.
L SY.atutes and City o't' Eaqan Ordi.nances.
-
APPLICANTlPERMITEE SIGNATURE ?SUED BY'-URE ?
CTTY OF EAGAN
3830 PIIAT KNOB RD - 55122
1998 FIREPLACE PERMIT APPLICATION
681-4675
DnTE:// - 1D g ?
DESCRIPTION OF WORK/:''? Constrvct new fireplace
?+% 10 Install Eas insert onlv na_ x_
Other
??-(0-9?
PERMIT FEE: $50.50
Alterations to existing
Install Pas line oniv
JOB ADDRESS: C-Y' / °L a5jP J ?
LOT: ? g BLOCK: SUBDMSION/P.I.D. # ? O
APPLICANT (circle one only): OWNER TRACTOR' I-C I hereby acknowledge that I have read this application and state that the information is correct
and agree to comply with all applicable State of Minnesota Statutes and City of Eagan
, n
Ordinances. -4Jic?',
? ?c.? c4 r0 tv?
Nazne: ? Phone #:
PROPERT'Y Last First
OWNER
Signature:
StreetAddress: T/q`Z- riYi% L-r 1 tc?-T 7-(z,
City v` State: iL/l K) Zip: S S I Z- Z
Compsny:"rnn-Ake- Phone #: 5?7i' ZS-ZS'
FIREPLACE ??
INSTALLER Signature:
Street Address: 4,P-v License # ililta
ciri suce: zip: ss-Y 3`z-
Company: ?$q m e, Phone #:
GAS LINE
INSTALLER Signature:
Street Address:
OFFICE USE ONLY
BUILDING PERNIIT TYPE
? 14 F'veplace
W ORK TYPE
D 31 New 0 33 Alterations
0 32 Addition ? 34 Repair
GENERAL WFORMATION
Census Code. 434
SAC Code Ol
REMARKS
Chimney/flue must be inspected before concealing.
3i
> l?
n` • ?_ ? ?
?
MH STA. 4+59
MH "^'
5 8.89 LT
`-, 5=0+50 '?
INVa901.90
, ' ;?9>>?9? 5 AiH STA {+24•. 1
; "., •., 1 MH f A.W. 99 ? 5=1+00? ` ? ?
? INV=904.61 \ ?' `' ±gp'
t CS=914.61
MH STA 3+3?'?-„''•
YH ?-SiA'-3+76 ?'?. r
? 5 &95 LT `
a.r-ti! I/ S
1AH STA. 2+21 $ Lal
MH ?SI.4-?+65 J?
2 9.02 LT,2 1
Ss1+67 W-0+12 mv-eaa,ag sos.7o
C5-9i4480. 915.10 ??' _
5=W82 ?5,_'___"•`\
INV-901.36 \
CS-911.J6
? UNOFMCRWND PoMfli CON[
umFACR0U/1D mPoGAllp1
mFACROU
'.E RIGHT AIH STA. 6+42 i [) n T[Nn?? r- n/I n n 1
py.p' MH ri-SIA.6+61 ? i/'! I\Ili( ? 1._n V."v •i /'111 /?
6 32.95 LT '
I
,.= y'"_"_' `"'"___'" 1+JB
- ', . .ar 13 5-+*896?.9 + I; 4 _ ?---o+n--------------- ---------------- s_,+ss••? .
INV= < 21a' CS=906.3 S=Bi-B? =i+55____ 1' ______' * INV.89Z2 •,
INVa696.7 INV=897.2 C5Z.0
CS=901.0 ?
? CS-90Z.0 , M19RANT
13.3!
7 ' i HWL = 895.8 MM STA. 1+64a1.0:, p.p 6'-90' BEND ;.
22'1",? NN'L = 894.0 CND. EL 903.0
7NH. EL 905
?1-8'-15' BENQ 1 I?? HYDRANT 780.32
??J
HYDRANT-'?.,J .? ??:: ' 6'-90' BEND ?• t - ?•nw'__ -.. ? i , 1 O* MY
(8'-22 1/2'?. li GNO. EL 900.0
D.5 ' 37'-8'DIP. LL 52 ?W93
? TNH. EL 901.95 2aY ao.s' INVa99G9
?1P 5=0+80 j ' 17.Y ' - GND. El. 908.3 _
1 7 l81.2' 6.!' 1 50.0' --£kEE ? • "- - ;
.E1.7 INV=900.01? I TNH. EL 908.52 S:O+B7 ""'_"_""_?" F'_•-__.__ CS=903.5
C5-910.011 ; C.O. 907.0 INVa896 5 13.Yt' _ •??? i, r= 8'-45' BEND INVa896.53 ' 5?1+12 MH ? STA. 8+72
1 6 1 CS=900.0 MH AS LOCATED INV=896.5 ? 6 32.95 LT /
14 9 MH STA. 1+91 1e.2' -' C5=905.21 v ?c ?J
fDRANT 5-1+21 ?0+36 I I 12?
a 6' T E E INVs896.9 { 5? 1+ i h p ? ? 6 I $ IC5?908.35` a 2 5 /'?
1, .15 I ? MM AS LOCATED 8.35? ; - a?
-6'OIP. CL 52 INV-897
? i I I ? I ?A
ID. EL. 914.2 ?906.3 i ? B MH STA. 1-6'-22 7/2' BEND ` ?
IH. 0.. 916.4 5?0+27 k:, € STA. 4+91 74.Yi
', ,, ?` •- e' 1
INV-905.23 -"
57.0' ?$ ? ". \ ? ? i •---_- '"_ 5 8.89 LT 1? ? '1-6' G.V. cw? SCAIE M t=
C5-915.23
7-8?6 ' BEND? Q 917. ? i i $ ' ? 9.8' • 8' t 6' REDUCEH
yyyp PoxiR CaNOWT ?
5 M.? H S?A 0+39 INVe904.0
` uND-.,Q+GaOUNO 4'7.0' 1•j INV-896.9
9.C 21.1' CS-906.3
??p 1 23 •RT t t 15 a 1AH ?t STA. 4+59 ? 1
r 4 W NEST ? ? s
19 INV=898.?j ? 1+78 MOY S'
? n:' i \•`??•?. • ~:?y ? 8' x 6' WCEH
. C5-90B.20' t 5.4+8¢
t_g,_RO?°'p? ICSa907.0 O END
il 8' x B' lEE 121'
i •?
+ MH MN STA Wo0 \ . .,k REMOVEVPLOG. CONNEC'I?'1?t` ?-e' G.V.
_ ' ? . . .. '_ _. .. • ? NOTES?
TO EXISL 8' DIP W.M. y , . ?? ?? l FT ,
7. SANITARY SEWER SERNCE WYES N2E
STATONED FROM DOWNSTRElJA M HOLES-
.??..?
1 -??CorA?a-_i
UFRtRax?D PoMER ALL SANITARY SEWER SERNCES SMALL
rN
.,..?..?r,. ;. ,?,..? •??,-?? ?,. ? ?' ?? ___ BE 4' P.V.C. (SOR 26).
lu?Xl?:n?
BENpiMARKS
, 3' UPSTREAM PRCY
.H. 3 SAN 71MyR $ERy1(2
T.N
? ALONC O-FFLEY ROAD
EAST SIOE OF WAIER TOWER 4. ALL WATER SERNCES WALL BE 1'
^,o I?, ?c? 0.= 990.38 (TYPE -K-) COPPER.
?d? uT?'AMBERLEAF.. TRAIL ? iIiiiC sc.U.C iN veeT * NOTE: ? T.N.M. SYf WAD 5. ALL O.I.P. WATERYAIN SNALL BE CLA55 .?
LOTS 10, 11 @ 12 MAY REWIRE WFFlEY ROAD k DANIQ DRIVE 52 l1NLE55 01HERM75E NOIm. %,-
, • _ ',? f•?:„' /?ptn ' ? I
? ._._ IV11?'1: PRIVAIE GftINDER PUMPS. 0. - 978.51
r
6. E%TEND SERNCES 15' PAST PROPERTY UNE.,
_. .... _ _ ....:... ::.... .............. .. . . . _ . ..... ........ _ .... ..... ....... ......... ..... ..... ..... ..... '_ .. .. .. . .. ....
? .. y?.;.... .. .... .. .... ... ..... ..
...
IT
925.
4 w_ .. .........:...... ...:.
.. . . ...... .... .....
. . ??.. ?,_ . . _ . . . .. .. ...... ....9t4.22...... .. ..... . .. .......... . ..... . ... ......... ... . .
.. . :?.: EXI571NG GRWND ? MF1..R . ..?.. :
913.54. _ . . - ' . .? . .'- :
z
920 zo?.eo' ..3: ?Y. _
_:. .._ ...:......:..:.........::..: . . _ . .
f. .... _ .. .. _
..
. : . ...... '..:.
. . . . ... .. ..'.
. ,IH RE =9i8-2S ' - ..
p. 4 _ BlDW6S&
SED GRADE-? : : . ? . . . AIH RE-^•-e ^'? . ' .
. . ' 4H RE?B6i.8? PROPO 7578'
/
. :.
915 soe.e7 . s ein?sa- i ?.
.. : .':. :
. . . . . . . .. '. ? '1 BLD .7442' . .? f? . . :. _ ... ... . ? MH RE 66P.63 915
..... .....
5 BlD-'-.?:z- . ._.... .... ..._ ... .' ......:.. . .. .. ..... MM?.RE._995.20.. .
906.08 , ..: . . . . .
\\
. . E% RE-965.?& 1d95' ? ... MH..?D90? .
?E70?ND C B 6 BLD?-iB+.Sb ?
: .' . : uH : ' : ' : . ' 20 . . ..
H REeBBi.L : : : 1 ' :
.32
8Lp MH ? B 902
' ?
R 2:9P
9?? =96 910
...' MHt1. •?8826
. . _ .. _ .. . . ... ... ....... ... . ? ... . .. . _ ..... 3? . . . . . . .. . .. .. . .
.. . ... .......... '.. .. ?. .
. . . . ' ..? .... '. . . . .. . . ' 6 . .... . . . .
. . . . ' ?p • . .: . . ...... 7 . .
. . . ? ' ? 7.5' uIN. BLD . . . S
'
. . P ? Q PROPOSED:CRADE 81'
?COVER 10
905 ' CONNECT TO ? -? B.O,? 7.5' MIN GRA
. DE? . ? . ' ? 905
:
. .. .. j.. ..__ . . . . P.?.... . ._ . ; .:. ..... : . . ? . .... ... .... ....... . CQVER '. _ ..... . ..... . ... . .... __ . . . ..._
.
' ? . . .. ..: .. .
/ '.. . E%iST: STF16
? wj e• G.V. sz . . ... '
7 5' WN.
900 rc °' ?C 5 900
COVER
. . .. .. ...._. . . J . . . .... .... . . . . . . . ? .... . ... . . .. . .... ._. ....
... .
. . Y? ..w.. ? . .'. L 2.' .. ' _ . . ? . .. .
...... . ..... .... .
. ... ..
6' D.I.P, Cl. Sp '
HIILO MANHOLE 0YL7t:
895 . ? E7a5T. B' PVC SN9
895
. . . ? ? . .. . .. .. .. . . . .... o o m ... '........ . . . . . ...... . .. ' .. .. .....
8'.DIP...CL52.0.??.3?' ...:....;..
'PVC'SO 35'trV:1BlF:. . 8- ? ... ?. yr ?I6i_
: . ' : : ' &5=8? PVC ? 8' R 0 - . .4 . .
:
.4 104 SDft 26 ? B SDR 25 . 164
890 ' NI` ?B' PVC??26 YB?BR
,o " 0.267I - 17W 0:6i9W : O.7BS 35' 0:0.4107F 0?4 , 64 LIN. FT. ? -:- :
i6Y o.2? I ; 3G-B' PVC SOR 26 0.75s? 2-2 . a' . e' 1-10-95
a. n n ezcsT. sTUe ?.. g .. : a v+e?-... wsuLanoN RECORD PLAM . 890 ,
m am u 39'19-8' PVC i . n . t.4R LAY ?IN 6F?P09TE..? .
? aR[cnow ,?, BUILT 8Y:
? ? ? EBAK CONS?
x xi> 0 ? > > m? E ? i
WI W2 2 . ? 2I ? Z . Z' 2 . . . 2 ? . Z Y 2' 2 Z . l?a5p' ^
? ?
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116360
Date Issued:10/07/2013
Permit Category:ePermit
Site Address: 4192 Amberleaf Tr
Lot:18 Block: 1 Addition: Rooney
PID:10-64560-01-180
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Kelly Meyer
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Christophe R Dolan
4192 Amberleaf Tr
Eagan MN 55123
Hause Construction, Jg
P O Box 206
Bayport MN 55003
(651) 439-0189
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA122032
Date Issued:04/22/2014
Permit Category:ePermit
Site Address: 4192 Amberleaf Tr
Lot:18 Block: 1 Addition: Rooney
PID:10-64560-01-180
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Heidi Hanschu
4342b Shady Oak Rd
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Christophe R Dolan
4192 Amberleaf Tr
Eagan MN 55123
Practical Systems
4342B Shady Oak Rd
Hopkins MN 55343
(952) 933-1868 X205
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r----------------"'�
I For Office Use �
. � � � ��� I
Clty of Ea�a� � Permit#: �
� �� �
� Permit Fee: � �
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 i Staff: i
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: ����� � �`��� � �� Phone:
Resident/ ��_l � �j.,�J'� �. �e2 i
Owner Address�city�zip:
Applicant is: Owner �Contractor
Description of work: [��/� ��/l
,Type of Work
Construction Cost: Multi-Family Building:(Yes /No )
Company: � Z���� `-@�'� .L��Contact: fa. °�� '��C"��
Contractor Address: ` �C�- � o�-� � �� �- ity: /12�a 7
y�� A, — !/`] /_ G� r,, I
State`�'"�"' Zip: `S5 �Y /Phone: (I��o���"`�mail: SIJ�-t.l l�'��� �Q7 ' c��
License#:_��(J/��� Lead Certificate#: �v���'C /�� `/
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
�,,(�—�'�"=�c �4 7�'
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes �o If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons fhat would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
X�_ " � ��Mc� . X . ,� WV� � C
Applica ' Printed Name icant' ignature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA150001
Date Issued:06/15/2018
Permit Category:ePermit
Site Address: 4192 Amberleaf Tr
Lot:18 Block: 1 Addition: Rooney
PID:10-64560-01-180
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ivan Broodryk
4192 Amberleaf Tr
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature